As you probably know and have experienced by now, working a daily 9-5 desk-bound job is not guaranteed to exclude you from repetitive stress pain. This pain is not unique to those working heavy jobs like construction, agriculture or even baggage claim handlers.
Is working in an office 9-5 so difficult and dangerous to our health?
First, the long hours spent sitting or even standing at the desk in combination with our lifestyle must be considered. Our bodies are designed to be active, to move freely and be engaged in a certain dynamic that ensures adequate circulation. Frequent movement helps keep us alert and ready to react.
Another major factor that is vastly underestimated and maybe one of the most important components involved in remaining pain free is proper posture.
Posture is defined as being the position of a person’s body or body parts, it’s the position in which the body is found before starting every movement and the position to which the body returns when completing set movement. 
Imagine your trunk, your core, as a tower comprised out of many floors represented by the vertebrae. We’re anatomically built in such a way that every one of these floors perfectly align with each other, thus providing stability. This system is also meant to conserve energy leaving muscles in their optimal condition, normal tension and length. Your body thrives when the need for exerting extra effort correcting imbalances is absent.
When your body lacks postural integrity by not maintaining the proper alignment, muscle pain, joint pain and varicose veins can ensue.
How does this imbalance wreak havoc on our body you may ask?
The answer is simple! The body as we know it should always be approached through a holistic manner.
Like in physics, where “every reaction has an equal and opposite action,” our bodies function following the same principle. An occurrence of muscle imbalance is always described through analysis of the agonist muscles, on one side, and the antagonist muscles, on the other side. Namely, biceps vs triceps. Shortening of one muscle group on one side will most certainly be followed by lengthening of the opposite muscle through reciprocal inhibition. This, in turn, will lead to poor joint stability which is a factor for pain and in worst case scenarios, arthritis of the shoulder and elbow joints.
Unfortunately, many of us who deal muscle severe imbalances are unable to identify the problem or even recognize its existence. Imbalances often occur between our abdominals and upper hamstrings and between your lower back and your hip flexors resulting in chronic lower back pain. Essentially, to be a fully balanced person, these four muscle groups must work together synergistically, each providing the same amount of effort to produce movement.
Whenever one of these muscle groups are either too tight or too relaxed, problems will gradually start to arise, progressing until a Lower-Crossed Syndrome is established.
Lower-Crossed Syndrome is defined as tightness of the thoracolumbar extensors which crosses with tightness of the extensor muscles of the legs. Weakness of the deep abdominal muscles crosses with weakness of the hip muscles. This pattern of imbalance creates joint dysfunction along with lower back pain, particularly at the inferior segment of the vertebrae and hip joint. Specific postural changes seen in LCS include anterior pelvic tilt, increased lumbar lordosis, lateral lumbar shift, lateral leg rotation, knee hyperextension. 
Although, as previously explained, the body should be looked at as whole, for didactical purposes, here are the two most common types of conditions encountered when either one of these muscle groups are predominant. For an easier comprehension of the problem I have resorted, for better visualization power, to the well-known cartoon characters, Donald Duck and The Pink Panther.
The Donald Duck syndrome
- Anterior pelvic tilt
- Inhibited / Weak: Abdominal muscles, Upper Hamstrings
- Facilitated / Tight: Thoraco-lumbar erectors, Hip Flexors
In simpler terms, to correct hyper-lordosis you need to BOTH lengthen the overly tight muscles (with massage, myofascial release and stretching) and strengthen the overly long/weak muscles (especially the glutes and abdomen)!
The Pink Panther syndrome
- Posterior pelvic tilt
- Inhibited / Weak: Thoraco-lumbar erectors, Hip flexors
- Facilitated / Tight: Abdominal muscles, Upper Hamstrings
In simpler terms, to correct hypo-lordosis you need to BOTH lengthen the overly tight muscles (with massage, myofascial release and stretching) and strengthen the overly long/weak muscles (especially the hip flexors)!
Causes for Pink Panther and Donald Duck
- Prolonged sitting, particularly with bad posture
- Physical inactivity
- Imbalanced strength training
Common signs and symptoms of Donald Duck Syndrome
- Lower back pain
- Anterior pelvic tilt (APT)
- Increased lower back curve
- Vicious knee position
These signs and symptoms, in combination with a screening that reveals stiff hip flexors, poor glute and abdominal strength are good indicators of LCS.
You’ve identified the problem, now what to do about it?
Lower back pain responds to treatment through lifestyle changes combined with physical therapy and or chiropractic. Rehabilitation consists of strengthening muscles that have been inhibited in conjunction with stretching the opposite muscle group. Here’s a list of stretches and strengthening exercises that you might find useful in dealing with lower back pain.
Lack of flexibility can be a major factor in the appearance of lower back pain. Taking that into account, it is important to set aside the misconception that you either are/are not naturally flexible and begin working to lengthen your muscles. The following stretches should be pain free so if you feel discomfort, stop what you are doing and come back to it when you feel ready.
- Quadriceps stretch
- Hip-flexor stretch
- Adductor stretch
- Hamstring stretch
- Dynamic hamstring stretch
- Side-lying hamstring stretch
- Glute stretch
- Prayer – cat – camel
Lumbar / Core strength and stability exercises
- Supine abdominal draw in
- Abdominal draw in with double knee to chest
- Bridging on elbows
- Side bridging on elbow
- Press ups
- Quadruped opposite arm/leg
- Supine butt lift with arms at side
- Prone bridging- “around the world” 
- Video to some of these exercises here
This alternative represents a real solution to our correcting an unhealthy way of sitting. The mechanism of these chairs is designed to divide the burden of one’s weight between the knees and the pelvis. Such benefits might be helpful to those experiencing lower back pain, reducing the discomfort and the fatigue usually associated with classic sitting positions.
Sitting for prolonged periods of time in such a dynamic chair results in less lumbar flexion and less back muscle activation compared to regular chairs, preventing slump sitting, thus favorizing a correct upright position. 
Smart Desk (Standing desk)
Ever since the standing desk has been introduced to the masses in 2012, it has taken world by storm. They’re marketed as the healthier alternative to sitting 40 hours a in office job. The principle benefit is reduced fatigue as they allow you to work while standing. Stations in the higher price range offer adjustable heights allowing them to accommodate a stand or sit position.
Although it’s been shown to reduce back pain due to of the more ergonomically correct position while working for prolonged periods of time, some major flaws have been identified. Worker reduced productivity, and in some cases, lack of concentration presented while standing up have been identified. The following recommendations must be taken into consideration while using such a desk:
- Alternate between standing and sitting
- Adjust your desk and screen
- Use arm supports and a small foot stool
- Take breaks every hour (a Fitbit watch might be useful)
Spinal manipulation by a Chiropractor
Paying a visit to an experienced chiropractor can offer you surprising results. Chiropractors are trained professionals specialized in relieving pain and in improving physical function by manipulation of your joints. Chiropractic treatment is aimed towards having your posture properly aligned, along with offering personalized advice on solving your work station obstacles, whether that being at home or at work. Such an alternative is aimed at solving the underlying problem!
- Paul Chek, “Effectively preparing clients for today’s functional exercise approaches”
- Janda V. 1987. Muscles and motor control in low back pain: Assessment and management. In Twomey LT (Ed.) Physical therapy of the low back. Churchill Livingstone: New York. Pp. 253-278.
- O’Sullivan, Kieran, et al. “Lumbar posture and trunk muscle activation during a typing task when sitting on a novel dynamic ergonomic chair.” Ergonomics 55.12 (2012): 1586-1595.
- Suzuki, Tetsu, et al. “Comparison of Trunk Muscle Activities and Spinal Curvature when Sitting on a Kneeling Chair and Sitting on a Conventional Chair — Investigation of Two Sitting Postures.” Rigakuryoho Kagaku. 2011, Vol. 26 Issue 2, p263-267. 5p.
Dr. Michael Moses is a chiropractor and educator. He is the founder of Arlington pain and rehab specializing in working with CrossFit, rugby and endurance athletes based out of Arlington, Virginia